Incident Report Form
Used to report and track usual or major unusual incidents. Every independent and agency provider must maintain a log of unusual incidents.
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MUI & UIR Forms
DODD's Major Unusual Incident and Registry Unit oversees county boards and providers to help ensure the health and welfare of people with disabilities who receive services.
What is an Unusual Incident (UI)?
An unusual incident, also called a UI, is an event or occurrence involving a person that is not consistent with routine operations, policies, and procedures, or the person's care or service plan, but is not a major unusual incident.
What is a Major Unusual Incident (MUI)?
Major unusual incidents, also called MUIs, are alleged, suspected, or actual occurrences of an incident when there is reason to believe the health and welfare of a person may be adversely affected or the person is placed at a likely risk of harm.
Types of Major Unusual Incidents
Accidental or Suspicious Death
The death of a person resulting from an accident or suspicious circumstances.
Attempted Suicide
When a person physically attempts to take their own life and it results in emergency room treatment, inpatient observation, or hospital admission.
Death Other than Accidental or Suspicious
Death of a person by natural causes.
Emotional Abuse
Actions, words, gestures, or patterns of behavior that threaten, coerce, intimidate, harass, or humiliate an individual.
Exploitation
The use of a person’s resources for personal benefit, profit, or gain.
Failure to Report
The failure to report abuse or neglect that resulted in a substantial risk of harm.
Improper Use of Behavioral Supports
Use of behavior supports, restraints, or interventions that are not approved or are used incorrectly.
Law Enforcement
An incident that requires law enforcement involvement or results in a police report.
Missing Individual
When a person cannot be located, and their whereabouts are unknown.
Neglect
Failure to provide adequate care, supervision, or services, resulting in harm or risk of harm.
Peer-to-Peer Acts
Incidents between individuals that result in injury or risk of harm.
Physical Abuse
Non-accidental use of physical force that causes injury or pain.
Prohibited Sexual Relations
Sexual conduct between a direct service provider and a person they support.
Rights Violation
A violation of the rights listed in Ohio Revised Code 5123.62 that creates a risk of harm.
Sexual Abuse
Any sexual contact or behavior with a person without their informed consent.
Significant Injury
An injury of unknown origin or an injury that is unusual or significant.
Theft, Misappropriation, or Property Damage
Taking or damaging a person’s property without permission.
Unauthorized Use of Seclusion or Restraint
Using seclusion or restraint when it is not authorized or permitted.
Verbal Abuse
Use of oral or written language to threaten, coerce, intimidate, harass, or humiliate an individual.
Recording and reporting
- Use the Incident Report Form to report an unusual incident.
- Every agency provider must maintain a log of unusual incidents with day, time, injuries, actions taken, contributing factors, and preventative measures.
- Review UI logs at least once per month to ensure appropriate preventive measures were implemented and to identify patterns or trends.
- Direct service providers must report UIs to designated staff within 24 hours of becoming aware of the incident.
- All incidents must be investigated; some require police or other agencies to be involved.
Forms and resources
Unusual Incident Report Log
A running log of unusual incidents that includes the day, time, injuries, actions taken, contributing factors, and preventative measures.
Open form/resourceUI and MUI Overview
DODD’s guide to reporting unusual incidents and major unusual incidents, including required reporting periods and methods.
Open form/resourceMajor Unusual Incidents
Full definitions and examples of each MUI type from DODD, plus reporting and investigation requirements.
Open form/resourceUI Logs and Investigations
Guidance on maintaining UI logs, investigating unusual incidents, and identifying patterns or trends.
Open form/resourceOAC 5123-17-02
The Ohio Administrative Code rule that defines MUI and UI reporting requirements for providers.
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